帕罗西汀联合尼麦角林治疗脑卒中后抑郁的疗效观察和炎症因子的影响
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摘要
目的探讨帕罗西汀联合尼麦角林治疗脑卒中后抑郁的临床疗效和对炎症因子的影响。方法我院收治的95例脑卒中后抑郁患者,按随机数字表法分为帕罗西汀联合尼麦角林(PL)组和帕罗西汀(PT)组。PT组给予盐酸帕罗西汀20mg qd。PL组在PT组基础上加尼麦角林10 mg tid。两组均治疗8周。观察治疗1、2、4、8周后两组临床疗效、心理状态及不良反应,并在上述时间点采集血清测量白细胞介(IL)-6、IL-8、肿瘤坏死因子(TNF)-α含量。结果 PL组总有效率高于PT组(P <0. 05),PL组在治疗1、2、4、8周后汉密尔顿抑郁量表(HAMD)评分均低于PT组(P <0. 05),两组不良反应发生率比较差异无统计学意义(P> 0. 05)。两组治疗后IL-6、IL-8、TNF-α水平均降低,且PL组下降幅度更大(P <0. 05)。结论对于脑卒中后抑郁患者,给予帕罗西汀联合尼麦角林治疗效果确切,优于单用帕罗西汀,有助于改善患者抑郁情绪和降低炎性因子水平。
Objective To explore the clinical efficacy of paroxetine combined with nicergoline in the treatment of post-stroke depression and the influence on inflammatory factors.Methods Ninety patients with post stroke depression in our hospital were divided into paroxetine combined with nicergoline group( PL group) and paroxetine group( PT group),45 in each group by using random number table method.The PT group was given 20 mg qd of paroxetine hydrochloride.The PL group was treated with 10 mg tid on the basis of the PT group.Both groups were treated for 8 weeks. The clinical efficacy,psychological status and adverse reactions of the two groups were observed at 1 week,2,4 and 8 weeks after treatment,and serum levels of IL-6,IL-8 and TNF-α were measured at the above time points.Results The total effective rate of the PL group was significantly higher than that of the PT group( P < 0. 05).After 1 week,2,4,and 8 weeks of treatment,the score of the Hamilton depression scale in the PL group was lower than that of the PT group( P <0. 05).There was no statistically significant difference in the incidence of adverse reactions between the two groups( P >0. 05).The levels of IL-6,IL-8 and TNF-α were significantly reduced in both groups after treatment,but the decrease was greater in the PL group than the PT group( P < 0. 05).Conclusion For patients with post-stroke depression,the treatment with paroxetine combined with nicergoline is better than paroxetine alone.It can improve the depression and reduce the level of inflammatory factors.
Objective To explore the clinical efficacy of paroxetine combined with nicergoline in the treatment of post-stroke depression and the influence on inflammatory factors.Methods Ninety patients with post stroke depression in our hospital were divided into paroxetine combined with nicergoline group( PL group) and paroxetine group( PT group),45 in each group by using random number table method.The PT group was given 20 mg qd of paroxetine hydrochloride.The PL group was treated with 10 mg tid on the basis of the PT group.Both groups were treated for 8 weeks. The clinical efficacy,psychological status and adverse reactions of the two groups were observed at 1 week,2,4 and 8 weeks after treatment,and serum levels of IL-6,IL-8 and TNF-α were measured at the above time points.Results The total effective rate of the PL group was significantly higher than that of the PT group( P < 0. 05).After 1 week,2,4,and 8 weeks of treatment,the score of the Hamilton depression scale in the PL group was lower than that of the PT group( P <0. 05).There was no statistically significant difference in the incidence of adverse reactions between the two groups( P >0. 05).The levels of IL-6,IL-8 and TNF-α were significantly reduced in both groups after treatment,but the decrease was greater in the PL group than the PT group( P < 0. 05).Conclusion For patients with post-stroke depression,the treatment with paroxetine combined with nicergoline is better than paroxetine alone.It can improve the depression and reduce the level of inflammatory factors.
引文
[1]王力,任会彩,王志先,等.脑卒中危险因素早期筛查与高危个体处理[J].脑与神经疾病杂志,2018,26(4):212-215.
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[5]周艳丽,孙斌,钱婀娜,等.尼麦角林对偏头痛患者脑血流动力学与血浆5-羟色胺的影响[J].中国实用神经疾病杂志,2017,20(7):30-33.
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[7]邓旭瑶,卓恺明,王静华.帕罗西汀联合阿普唑仑治疗对老年脑卒中合并焦虑抑郁患者抑郁自评量表、汉密尔顿抑郁量表评分的影响[J].中国老年学杂志,2016,36(15):3694-3695.
[8]Nakase T,Tobisawa M,Sasaki M,et al. Outstanding Symptoms of Poststroke Depression during the Acute Phase of Stroke[J]. PLoS One,2016,11(10):e163-164.
[9]Andorson G,Vestorgaard K,Ingemarrn M,et al.Risk Factors for Poststroke Depression:An Integrative Review[J]. J NeurosciNurs,2017,49(2):E1-E2.
[10]Li J,Oakley LD,Li Y,et al.Development and initial validation of a clinical measure to assess early symptoms of post-stroke depression in the acute stroke patient[J].J ClinNurs,2018,27(3-4):784-794.
[11]Park EY,Kim JH.An analysis of depressive symptoms in stroke survivors:verification of a moderating effect of demographic characteristics[J].BMC Psychiatry,2017,17(1):132.
[12]Liang Y,Chan YL,Deng M,et al. Enlarged perivascular spaces in the centrum semiovale are associated with poststroke depression:A3-month prospective study[J]. J Affect Disord,2018,22(8):166-172.
[13]Tessier A,Sibon I,Poli M,et al.Resting Heart Rate Predicts Depression and Cognition Early after Ischemic Stroke:A Pilot Study[J]. J Stroke Cerebrovasc Dis,2017,26(10):2435-2441.
[14]Xiao M,Wang Q,Ren W,et al.Impact of prediabetes on poststroke depression in Chinese patients with acute ischemic stroke[J]. Int J Geriatr Psychiatry,2018,33(7):956-963.
[15]李丽平,费鹏鸽,宋景贵.选择性5-羟色胺再摄取抑制剂治疗卒中后抑郁疗效的Meta分析[J].新乡医学院学报,2015,32(3):235-238.
[16]谢双燕,周伯荣,胡佳佳,等.帕罗西汀提高绝经后焦虑/抑郁患者的雌激素水平和认知功能[J].中国神经免疫学和神经病学杂志,2015,22(1):30-33.
[17]Tsai CS,Wu CL,Hung TH,et al.Incidence and risk factors of poststroke depression in patients with acute ischemic stroke:A 1-year prospective study in Taiwan[J].Biomed J,2016,39(3):195-200.
[2]Torrisi M,De Cola MC,Buda A,et al.Self-Efficacy,Poststroke Depression,and Rehabilitation Outcomes:Is There a Correlation[J]. J Stroke Cerebrovasc Dis,2018,27(11):3208-3211.
[3]Towfighi A,Ovbiagele B,El HN,et al.Poststroke Depression:A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association[J]. Stroke,2017,48(2):e30-e43.
[4]丁红运.帕罗西汀治疗脑卒中后抑郁症的临床疗效和安全性及作用机制[J]中国实用医药,2016,11(24):123-124.
[5]周艳丽,孙斌,钱婀娜,等.尼麦角林对偏头痛患者脑血流动力学与血浆5-羟色胺的影响[J].中国实用神经疾病杂志,2017,20(7):30-33.
[6]戴云飞,肖泽萍.中国精神障碍分类与诊断标准第3版与国际疾病分类第10版的比较[J].临床精神医学杂志,2013,23(6):426-427.
[7]邓旭瑶,卓恺明,王静华.帕罗西汀联合阿普唑仑治疗对老年脑卒中合并焦虑抑郁患者抑郁自评量表、汉密尔顿抑郁量表评分的影响[J].中国老年学杂志,2016,36(15):3694-3695.
[8]Nakase T,Tobisawa M,Sasaki M,et al. Outstanding Symptoms of Poststroke Depression during the Acute Phase of Stroke[J]. PLoS One,2016,11(10):e163-164.
[9]Andorson G,Vestorgaard K,Ingemarrn M,et al.Risk Factors for Poststroke Depression:An Integrative Review[J]. J NeurosciNurs,2017,49(2):E1-E2.
[10]Li J,Oakley LD,Li Y,et al.Development and initial validation of a clinical measure to assess early symptoms of post-stroke depression in the acute stroke patient[J].J ClinNurs,2018,27(3-4):784-794.
[11]Park EY,Kim JH.An analysis of depressive symptoms in stroke survivors:verification of a moderating effect of demographic characteristics[J].BMC Psychiatry,2017,17(1):132.
[12]Liang Y,Chan YL,Deng M,et al. Enlarged perivascular spaces in the centrum semiovale are associated with poststroke depression:A3-month prospective study[J]. J Affect Disord,2018,22(8):166-172.
[13]Tessier A,Sibon I,Poli M,et al.Resting Heart Rate Predicts Depression and Cognition Early after Ischemic Stroke:A Pilot Study[J]. J Stroke Cerebrovasc Dis,2017,26(10):2435-2441.
[14]Xiao M,Wang Q,Ren W,et al.Impact of prediabetes on poststroke depression in Chinese patients with acute ischemic stroke[J]. Int J Geriatr Psychiatry,2018,33(7):956-963.
[15]李丽平,费鹏鸽,宋景贵.选择性5-羟色胺再摄取抑制剂治疗卒中后抑郁疗效的Meta分析[J].新乡医学院学报,2015,32(3):235-238.
[16]谢双燕,周伯荣,胡佳佳,等.帕罗西汀提高绝经后焦虑/抑郁患者的雌激素水平和认知功能[J].中国神经免疫学和神经病学杂志,2015,22(1):30-33.
[17]Tsai CS,Wu CL,Hung TH,et al.Incidence and risk factors of poststroke depression in patients with acute ischemic stroke:A 1-year prospective study in Taiwan[J].Biomed J,2016,39(3):195-200.